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Microsoft PowerPoint - are dental implants right for you
 

Microsoft PowerPoint - are dental implants right for you

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    Microsoft PowerPoint - are dental implants right for you Microsoft PowerPoint - are dental implants right for you Presentation Transcript

    • Are Dental ImplantsRight for You?The Facts Asbjørn Jokstad, DDS, PhD Professor and Head, Prosthodontics Nobel Biocare Chair in Prosthodontics Faculty of Dentistry, University of Toronto
    • Questions
    • 1. What is a dental prosthesis?Crown Bridge “etch-bridge” (“FPD”)Fixed (Tooth-supported)
    • 1. What is a dental prosthesis? Tooth + Gum - support “RPD” Removable Gum-supported “Denture”
    • 1. What is a dental prosthesis? Tooth +Crown Bridge “etch-bridge” Gum - (“FPD”) support Fixed (Tooth-supported) “RPD” Removable Gum-supported “Denture”Replaces mostly Replaceshard tissue hard + soft tissues
    • 2. What are dental implants?Beginning in the 1950s researchersobserved that the metal titanium formed avery strong bond to surrounding bone, aprocess termed "osseointegration."After years of careful research and study,dental implants (titanium cylinders placedinto the jawbone to support replacementteeth) were refined with high success rates.
    • 2. What are dental implants?Implants are artificial tooth roots, made ofpure titanium or titanium-alloy, which areinserted into the jaw, where it performs thefunction of the root of a natural tooth thathas been lost.A replacement tooth, made by a dentaltechnician, almost indistinguishable from itsnatural counterpart, is attached to thisimplant by the dentistDental implants can be regarded assubstitutes for the roots of missing teeth.
    • 3. How can dental implants support a dental prosthesis?Dental implants act as anchors for areplacement tooth or crown or a set ofreplacement teeth.The patient gets a solid replacementthat looks like the natural tooth.
    • 3. How can dental implantssupport a dental prosthesis?Replacement of single teeth
    • 3. How can dental implantssupport a dental prosthesis? Implants for bridge-support
    • 3. How can dental implantssupport a dental prosthesis?For securing a removable denture
    • 3. How can dental implants support a dental prosthesis? (Tooth-supported) Fixed (Tooth+gum or gum -supported)Implant-supported Removable
    • 4. Benefits of implant-supported compared to conventional removable dental prostheses?Many patients report improvement overconventional dentures, such as: Replacement teeth look, feel and function more like natural teeth Improved taste and appetite Improved cosmetic appearance The ability to chew without pain or gum irritation
    • 4. Benefits of implant-supported compared to conventional removable dental prostheses?Most patients can eat and chew againwithout pain or irritation. Foods thatwere unavailable are now back in thediet.
    • 4. Benefits of implant-supported compared to conventional removable dental prostheses?Foods that were unavailable are back in the diet.Implants eliminate the need fordistasteful adhesives. There is nolonger a need to use "glue" when thedental prosthesis is supported byimplants.
    • 4. Benefits of implant-supported compared to conventional removable dental prostheses?Foods that were unavailable are back in the diet.There is no longer a need to use "glue" .Implants can improve the taste of food.With less plastic covering the roof of themouth, most patients can enjoy naturalflavors and sensations again.
    • 4. Benefits of implant-supported compared to conventional removable dental prostheses?One additional and very important benefitcan be the reduction or elimination of boneshrinkage or “atrophy”, commonly relatedwith loss of teeth.Bone atrophy not only affects jaw function,but can cause adverse facial cosmeticchanges.
    • 4. Benefits of implant-supported compared to conventional removable dental prostheses?Implants can improve the patient’s healthwith the ability to chew a wider variety offoods: Eat whatever one like.
    • 4. Benefits of implant-supported compared to conventional removable dental prostheses?Implants can improve the patient’s health with theability to chew a wider variety of foods: Eat whateverone like.Implant supported restorations helpincrease ones self-esteem. Smile withconfidence.
    • 4. Benefits of implant-supported compared to conventional removable dental prostheses?Implants can improve the patient’s health with theability to chew a wider variety of foods: Eat whateverone like.Implant supported restorations help increase onesself-esteem. Smile with confidence.Implants increase the retention andstability of the teeth. Express oneselfclearly or simply be understood.
    • 4. Benefits of implant-supported compared to conventional removable dental prostheses?Implants can improve the patient’s health with theability to chew a wider variety of foods: Eat whateverone like.Implant supported restorations help increase onesself-esteem. Smile with confidence.Implants increase the retention and stability of theteeth. Express oneself clearly or simply beunderstood.Decrease the likelihood of continuedbone loss and improve ones externalfacial structure.
    • 4. Benefits of implant-supported compared to conventional fixed dental prostheses?Adjacent teeth can be preserved when, forinstance, teeth are lost in an accident.
    • 4. Benefits of implant-supported compared to conventional fixed dental prostheses?Adjacent teeth can be preserved.A bridge does not offer this possibility asthe teeth next to the gap have to beabraded and crowned.Implants do not disrupt or negativelyimpact other healthy teeth in the mouth.
    • 4. Benefits of implant-supported compared to conventional fixed dental prostheses?Adjacent teeth can be preserved.A bridge does not offer this possibility as the teeth next to thegap have to be abraded and crowned. Implants do notdisrupt or negatively impact other healthy teeth.Dental implants help the patient to keeptheir remaining teeth, because they areable to “share the load” with theprosthetic teeth.
    • 5. What are the steps for implant prosthetic treatment? (1/4)A titanium screw is inserted into thejaw bone where there are no teeth. Stage 1 surgery
    • 5. What are the steps for implant prosthetic treatment? (2/4)A titanium screw is inserted into thejaw bone where there are no teeth.The screw is then protected with acover, and the jaw is given a fewmonths to heal. Stage 1 surgery
    • 5. What are the steps for implant prosthetic treatment? (3/4)A temporary crown, etch-bridge orremovable prosthesis is used tominimize any cosmetic orchewing inconvenience.
    • 5. What are the steps for implant prosthetic treatment? (4/4)A titanium screw is inserted into the jaw boneThe screw is covered + a few months to heal.The final step is to uncover the implantand attach the permanent crown to theimplant. Stage 2 Surgery
    • Video
    • 6. How long does implant prosthetic treatment take?The healing time for implants is similarto time required for a broken bone tomend.
    • 6. How long does implant prosthetic treatment take?The healing time for implants is similar to timerequired for a broken bone to mend.Depending on physical and medicalsituation, the titanium implants fuse tobone in the jaw in the space of 2-6months.
    • 6. How long does implant prosthetic treatment take?The healing time for implants is similar to timerequired for a broken bone to mend.Depending on physical and medical situation, thetitanium implants fuse to bone in the jaw in thespace of 2-6 months.Treatment for the simple cases couldtake anywhere from 4-8 months, basedon where the implants are placed andthe type of restoration desired.
    • 6. How long does implant prosthetic treatment take?The healing time for a broken bone to mend.Titanium implants fuse to bone : 2-6 mthsTreatment for the simple cases: 4-8 mthsIf a tooth is extracted, the time to healis usually 6 – 12 weeks before theimplant is placed at the point where thetooth was removed.Recent advances by implantmanufacturers are reducing the timefor initial implant procedures.
    • 7. Can I extract a tooth and restore it immediately using a dental implant?Some dentists place dental implantsimmediately after tooth extractionSome dentists even place a temporaryor permanent restoration on the dentalimplant immediately after surgicalplacementThere seems to be a higher risk ofunsuccessful treatment outcome withthese approaches
    • Before treatment
    • 8. Who provides implant- supported dental prostheses?The general dentist is usually the firstresource for this service.The key is the implant dentists training,experience and credentials.Competent dentists include generaldentists, periodontists, prosthodontistsand oral surgeons who perform thesurgical and/or restorative procedures.
    • 8. Who provides implant-supported dental prostheses?Since implant prosthodontics usuallyinvolve two phases of treatment: 1.surgical placement of the implant and 2.placement of the restoration some dentistsfeel they can offer better care by using thedifferent expertise of other team members,e.g. performing the surgery or therestoration.Other practitioners feel that performingboth the surgery and the restoration withinone office is optimal for many patients.
    • 8. Can any licensed dentist legally perform implant surgery or restoration?Yes. However, education and experience iscritical. The dentist or dental specialistshould be questioned about his or hertraining in implant therapy and in-officeimplant experience.A recommendation should be requestedfrom ones own dentist if he or she is notinvolved in implant therapyAnother possibility is to talk to treatedpatients of record and to referring dentists
    • 8. Is it safe to have dental implant surgery performed outside thehospital, in an office-based facility?Most cases are. Safety refers to thenature of the procedure and themedical andor anesthetic needs ofthe patient
    • 9. Am I too old or too frail for implant-supported prostheses?Dental Implant patients are of all agesDental implants may be the right choice foranyone missing one or more teeth due toinjury, disease or decay.Dental implants are especially practical forpatients who can no longer wear removableprostheses.Good health and adequate bone are themost critical factors in evaluating implantcandidates
    • 9. Am I too old or too frail? (1/2)Dental implants cannot be placed when: Vital anatomical structures can be damaged There is still active skeletal growth There is active infection & inflammation There are general surgical contraindications Systemic diseases are likely to compromise the implant surgery
    • 9. Am I too old or too frail? 2/2Dental implants are more unpredictable if : insufficient bone insufficient space Previous radiation therapy of head & neck Skeletal discrepancies Poor quality bone Current or past history of drug/alcohol abuse Extensive tobacco use Poor oral hygiene Severe tooth grinding or clenching
    • 10. Do I have enough bone?It is important for a patient to haveenough bone to support the implant.If there is not enough bone, there aremany safe and effective ways to correctbone deficiency.A thorough clinical and radiologicalexamination will usually determine if it isadvisable to add additional bone material
    • 11. What Do I Need to Do to Prepare for Dental Implants?As is the case for any surgery, it is best ifthe patient is in good health.Smoking and excessive drinking canhave a negative affect on the process,and may cause dental implants to fail.Many dentists will require that the patientshould quit smoking before beginning thedental implant treatment process.
    • 12. Are there alternatives to dental implants?Traditional dentistry can providereplacements for missing teeth usingbridges, removable partials anddentures; however, each of these hasits problems.The dentist should describe allreasonable alternatives beforeproceeding to make a treatmentdecision together as to what is best forthe patient.
    • Single toothlost Etch-bridge Fixed bridge Removable dental Implant-supported crown prosthesis
    • Partially Edentate Upper Jaw Front Fixed bridgeImplant-supported FDP Removable dental prosthesis
    • Partially Edentate Lower Jaw Front Fixed bridgeImplant-supported FDP Removable dental prosthesis
    • Partially Edentate Upper Jaw Fixed bridgesImplant-supported FDP Removable dental prosthesis
    • Partially Edentate Lower Jaw Fixed bridgesImplant-supported FDP Removable denture
    • Edentate upper jaw Fixed bridges Implant-Implant- supportedsupported FDP RDP RDP Removable denture
    • Edentate lower jawImplant-supported FDP Implant-supported RDP Removable denture
    • 13. How Much Do Dental implants Cost?The cost of dental implants depends on thetype of implant received and the health of thepatient’s mouth, jaw and gumsThe cost of implanting one tooth can beanywhere between $1,600 to $5,000, and afull mouth reconstruction can be as much as$50,000.Dental implants rarely fail, so the patientdoesn’t need to buy them twice.Check with the dental insurance to see whatportion of the dental implant cost they maycover
    • 13. Are dental implants expensive?There is a greater initial investment fordental implants compared to denturesand partials.They should last for years, particularlyif there are no anatomical hindrancesIndependent surveys of implantpatients show that they felt theinvestment was worth every pennyand would do it again.
    • 14. What happens during the treatment planning phase?1. Prosthodontic assessment: 2. Surgical consultation: 3. Radiological assessment
    • 14. What happens during the treatment planning phase?
    • 14. What happens during the treatment planning phase?Computer x-rays
    • 15. What material are Dental implants made of?Titanium, titanium alloys or surfacesthat are coated with titanium are usedPure titanium intended for medicalapplications is used, which does notcause any known intolerance reactionsor allergies.Titanium is a very resistant material inthe body and is biologically inertA decreasing number of dental implantsare made from calsium-phosphate
    • 16. Is one dental implant system better than the others?There are many Health Canada & FDAapproved implant systems available toCanadian dentists.Many shapes, sizes and brands ofdental implants are available.More than 80 different dental implantmanufacturers market about 250 dentalimplant systems
    • Under and after the surgery
    • 17. What happens during the (first stage) surgery?1. A sedative for relaxation if desired2. Patient will be awake and able to communicate with the surgeon (although drowsy if sedative is taken).
    • 17. What happens during the (first stage) surgery?1. A sedative for relaxation if desired2. Patient will be awake and able to communicate with the surgeon (although drowsy if sedative is taken).3. A local anaesthetic is normally sufficient4. Patient is covered with sterile drapes.
    • 17. What happens during the (first stage) surgery?1. A sedative for relaxation if desired2. Patient will be awake and able to communicate with the surgeon (although drowsy if sedative is taken).3. A local anaesthetic is normally sufficient4. Patient is covered with sterile drapes.5. An incision is made in the tissues overlying the bone in the proposed implant site(s)6. The tissues are pulled back so that the surgeon can gain access to the bone
    • 17. What happens during the (first stage) surgery?1. A sedative for relaxation if desired2. Patient will be awake and able to communicate with the surgeon (although drowsy if sedative is taken).3. A local anaesthetic is normally sufficient4. Patient is covered with sterile drapes.5. An incision is made in the tissues overlying the bone in the proposed implant site(s)6. The tissues are pulled back so that the surgeon can gain access to the bone7. Gently drilling of the site(s) for the dental implant(s).8. Placement of the implants in the prepared sites9. Suturing healing
    • 18. Do I get my teeth immediately after surgery?The dentist will ensure that in theinterim healing period, the patient’slook and feel is made natural.Thus, the patient will normally neverneed to be without teeth.Check in case of referral to surgeonspecifically for implant surgerywhether interim teeth will be deliveredimmediately following surgery.
    • 19. Does it hurt afterwards?Usually, discomfort is not a problem.In fact, many have said that having atooth pulled was more painful.For the placement of an implant(s), thedentist will use one of many anestheticregimens so there wont be anydiscomfort.After the surgery, when leaving theoffice, appropriate medications willnormally be provided.
    • 20. Can I go to work after surgery?For single implants, the recovery timeis often less than it would take torecover from a regular toothextraction.
    • 20. Can I go to work after surgery?For placement of multiple implants under an existing denture, recovery may vary. In very rare instances, it can take up to a week before the patient is comfortable enough to resume normal activities.
    • 20. Can I go to work after surgery?For placement of multiple implantsunder an existing denture, recoverymay vary.In very rare instances, it can take up to aweek before the patient is comfortableenough to resume normal activities.It is advised to often cleanse the siteof surgery by vigorous rinsing andswishing of warm salt water todislodge any debris clinging to thesutures.
    • 20. Can I go to work after surgery?For placement of multiple implants under anexisting denture, recovery may vary.In very rare instances, it can take up to a weekbefore the patient is comfortable enough to resumenormal activities.It is advised to often cleanse the site of surgery byvigorous rinsing and swishing of warm salt water todislodge any debris clinging to the sutures.Liquid food for the first 2 days followingsurgery and a soft diet for 10 days isadvisable while the gums are healing.Eating hard foods during this period,e.g. steak and nuts, is discouraged
    • 21. Are there risk of complications during surgery ?Including, but not limited to, bleeding and bruisingPost-surgical pain Temporary speech problemsDelayed healing Post-surgical infectionBone fracture Loss of bony ridgeOsteomyelitis Damage to opposing dentitionChronic pain Local or systemic infectionAbscess Fistula to nose or sinusSequestrum HaematomaGingivitis Transient or permanent damage to the nerves in the jaw
    • 22. What’s the difference between “one-” and “two-stage” surgery?Two surgical procedures techniques are used:Single stage technique The dental implant is inserted and remain exposed in the mouthTwo stage techniqueOne-stage surgery: The dental implant is inserted and covered over to not be exposed in the mouthTwo-stage surgery: The dental implant is uncovered and exposed in the mouth
    • Restorative phase
    • 23. What happens during the restorative treatment phase?
    • 23. What happens during the restorative treatment phase?
    • 23. What happens during the restorative treatment phase?
    • 23. What happens during the restorative treatment phase?
    • 23. What happens during the restorative treatment phase?
    • 23. What happens during the restorative treatment phase?
    • 24. How long does it take before I get my teeth?This depends on the type of dentalrestoration required - usually it takesaround 4-12 weeks.Treatment time can vary greatly. Eachsituation needs a separate evaluation
    • After treatment
    • 25. What will it feel like when it is done?Once the entire procedure is completeand the final restorations placed, animplant supported fixed dentalprosthesis will actually feel or functionlike natural teeth.
    • 26. Risks and Discomforts following treatmentFor the last ten years, success rates atmany treatment centers areconsistently over 90% with properpersonal and professional care.Few forms of medical, orthopedic ordental treatment have such highsuccess rates.
    • 26. Risks and Discomforts following treatmentFailure of the implant or attached restorative workThis might require removal of an implant(s), remaking part of the dental restoration, or constructing an alternative prosthetic appliance to replace the missing teeth.
    • 26. Risks and Discomforts following treatmentFailure of the implant or attached restorative workThis might require removal of an implant(s), remaking part of the dental restoration, or constructing an alternative prosthetic appliance to replace the missing teeth.If an implant has to be removed (“explanted”), a local anaesthetic is administered.The implant is subsequently removed with the aid of a drill which fits over the implant
    • 26. Risks and Discomforts following treatmentFailure of the implant or attached restorative workThis might require removal of an implant(s), remaking part of the dental restoration, or constructing an alternative prosthetic appliance to replace the missing teeth.If an implant has to be removed (“explanted”), a local anaesthetic is administered.The implant is subsequently removed with the aid of a drill which fits over the implantDepending on circumstances, another implant may be placed after 3 months healing
    • 26. Risks and Discomforts following treatment Perfect resultOpacity (due to Exposed implantmisalignment) Adjacent toothGum inflammation damage
    • 27. How long do dental implants last?As a general rule it can be said that thebetter care the patient takes of the mouthand teeth, the longer the implants will last.Given correct oral hygiene and regularcheck-ups by a dentist (known as recalls),dental implants can last for decades.If properly followed up, one should expectimplants to last for 10 years, but there arepatients who have had solid dental implantsfor 35 years.
    • 28. How do I take care of my implants?Normal routine home care andprofessional cleaning visits are advised.Most dentists will offer special trainingand professional dental cleaning.Taking care of ones teeth neverthelesshas a major influence on the long-termsuccess of the dental implants.
    • 28. How do I take care of my implants?Patients should have a routine cleaningand re-care treatment and evaluationregularly – varying between 4 to 12 monthsdepending on treatment.An individualized program is usuallydesigned for the patient to optimally carefor their new teeth
    • Bottom line….Dental implants are an effective,safe and predictable solution tothe problems resulting frommissing teeth.
    • Thank you for yourkind attention